Storytelling evidence into practice in health and social care

Storytelling

Nick Andrews, John Gabbay, Andreé Le-May, Emma Miller, Alison Petch and Martin O’Neill

Getting research into practice is easier said than done, particularly in fast-paced and often under-resourced health and social care services. This is the story of how we achieved a good measure of success by taking a caring, inclusive and storytelling approach across six sites in Wales and Scotland, involving older people, carers, practitioners, managers and researchers talking and learning together.  

On the understanding that human beings are relational and storytelling animals, who make sense of the world through narrative and dialogue, we developed a story-telling approach to using evidence, which started by developing what has been described as an ‘enriched environment of care and learning’[1]. Within such an environment, everyone involved should gain a sense of security, continuity, belonging, purpose, achievement and significance. To enable this, we started with their priorities and valued their evidence (i.e. practice knowledge, lived experience of older people and carers and organisational knowledge), alongside the research evidence, which we were careful not to impose on them. A challenge for the research team was how to do this.

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To understand evidence use, understand the goals of decision makers

Sign

Justin Parkhurst

What does it mean to use evidence in policymaking? This seemingly simple question has been remarkably under-defined in all the calls for increased use of evidence. Indeed, many of those who champion ‘evidence-based policymaking’ do little to explain what it means for a policy to be evidence-based, and have trouble explaining what evidence use actually means when decision makers have multiple competing goals and social concerns. Evidence is simply seen as a good thing – and more use is better – without really considering what that means or what happens when there is disagreement around which evidence to use for what goals.

Policy scholars who study evidence, on the other hand, have approached the issue from the perspective that ‘evidence use’ can mean any number of things within a policy setting. The literature can, therefore, appear divided into two extremes: either evidence use is taken for granted to be a known (assumed to be good) thing, with little consideration of political realities, or alternatively it is seen as multidimensional, the form of which is constructed by the nature of policy ideas, processes, and interactions.

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Thought experiments with ‘fake’ research abstracts help policy makers visualise actions to be taken on evidence

Scrabble

Our university-policy maker partnership produces ‘fake’ abstracts of articles we’ve not written yet (on results we frankly don’t even know we’ve got) to loosen up thinking. It helps the team visualise pathways for policy action.

Penelope Hawe

Ours is a tricky situation, politically-speaking. A health department is undertaking Australia’s largest ever scale-up of evidence-based childhood obesity programs into every school and childcare centre across the state.[1] It costs $45m. They have an electronic data monitoring system in place. It’s already telling them that targets are being met. But rather than just rest on their success, they invite a team of researchers to do a behind-the-scenes, no-holds-barred ethnography. It could reveal the ‘real’ story of what’s goes on at the ground level.[2]

Foolhardy or brilliant?

I’m opting for brilliant. But let me put this in context. New South Wales Health is renowned for being research-savvy. They invest heavily in research capacity building. I’m talking in-house research, strategic investment, partnership research and peer reviewed publications.[3] The CVs of some of the policy makers in our partnership put some of us at universities to shame really.

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How educators and policy makers think differently about research

Policy makers are working hard to promote the use of research in education. But, does ‘research’ mean the same thing to policy makers and educators? While this question might seem basic, it’s important to know if policy makers and educators are speaking the same language.

Jennifer Lawlor, Kathryn McAlindon, Kristen Mills, Jennifer Neal and Zachary Neal

In this blog, we discuss the findings of our recent research article, ‘What is research? Educators’ conceptions and alignment with United States federal policies‘, published in Evidence & Policy, which has been awarded the 2019 Carol Weiss Prize.

It examines similarities and differences between educators’ definitions of research and the definitions used in US Federal education policy. Our findings show that educators tend to focus on the process and products of research, while policy definitions focus on data and outcomes.

Over the course of 90 interviews with educators, we began to notice patterns in the way educators defined research. This presented an opportunity to pause and ask: what differences exist in the way educators and policy makers think about research? Because US Federal policies such as No Child Left Behind (NCLB) and the Every Student Succeed Act (ESSA) encourage or mandate the use of research, the stakes are high for educators to comply. So, if educators and policy makers are on different pages about what counts as ‘research’, this can be a problem. At the same time, finding ways to bring educators’ and policy makers’ perspectives into alignment can help support collaboration between these groups.

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Beyond ‘context matters’: Learning from the African evidence community

Using Evidence cover

Ruth E. Levine

‘Wouldn’t it be great if the evidence-to-policy work we’re seeing on the rise in Africa could be visible to a wider audience?’ That was the question my colleagues at the William and Flora Hewlett Foundation and I had on our minds in 2017, seeing the creativity and resourcefulness of a host of organisations and champions from the region as they advanced a complex agenda. Now, just a few years later, the opportunity to learn from African experiences is realised in the volume Using Evidence in Policy and Practice: Lessons from Africa, edited by Ian Goldman and Mine Pabari (Routledge, 2020). The book, which both articulates a conceptual framework for thinking about the elements of a contextually-determined evidence ecosystem and presents eight case studies about diverse experiences, adds immeasurably to the literature on evidence-informed decision making.

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Decision-makers should listen to youth and new research shows how this can work

This blog post is the third in a series of posts linked to the Evidence & Policy special issue (Volume 16, Issue 2) on Opening up evidence-based policy: exploring citizen and service user expertise. Guest Edited by Ellen Stewart, Jennifer Smith-Merry, and Marc Geddes.

Scott Warren

I am the co-founder and chief executive officer of Generation Citizen, a non-governmental organization in the United States of America that seeks to empower young people to become engaged and effective citizens, and the author of the 2019 book Generation Citizen: The Power of Youth in Our Politics. At Generation Citizen, we are deeply committed to closing the civic engagement gap.  We offer school-based action civics programming, which provides young people with the opportunity to learn how to affect policy change and work together to take action on a local community issue.  Thousands of Generation Citizen classes have completed these action projects since our founding over a decade ago, and so I have witnessed firsthand the importance and influence of citizen and service user knowledge– in this case, youth knowledge– in informing policy and school decision-making. When students work together to generate relevant evidence and offer evidence-informed ideas of possible solutions, decision-makers should listen.  Sometimes students’ lived experiences can uncover outdated regulations that need updating, or work to better support their most marginalized classmates and their families. Yet, too few decision-makers are listening to youth, especially youth from marginalized backgrounds, and we must do more to facilitate incorporating lived experiences into policy. This is one of the reasons why Generation Citizen has worked to support efforts around the USA to lower the voting age to 16, to create an additional incentive for political leaders to listen to youth.  

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Spain needs a legislative science advice mechanism: lessons to learn from COVID-19

Emilia Aiello, Lorenzo Melchor, and Eduardo Oliver

Eurobarometer (2014) data on public perceptions of science, research and innovation revealed the Spanish population has high expectations of the role that scientific and technological development can play in improving key public policies (e.g. health and medical care, education and skills, transport and infrastructure). Yet unlike Norway, the UK or France, the Spanish national Parliament does not have any permanent legislative scientific and technological advice mechanism to act as an independent, cross-party, proactive and accessible source to inform debate and the policymaking process. Perhaps surprisingly, Spanish political parties all seem to agree on both the positive role that evidence can play in informing effective policymaking and the need to implement an independent advisory mechanism. This has been evident throughout the multiple public debates surrounding the initiative #CienciaenelParlamento (Science in Parliament), which emerged in January 2018, with the aim of closing the gap between science and society and better engaging scientists and parliamentarians.

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